Saturday, November 19, 2011

one big headache!

I have a conundrum. I have had daily headaches for the past 5 weeks or so. They are significant headaches, not nagging, more like harassing. I don't remember when they started exactly, but I do remember being surprised when I didn't have a headache on Oct. 22nd. I would guess that it had gone on consistently for about 7-10 days prior to that. They start in the early afternoon and ramp up to their worst before dinner. After dinner they usually seem to fade away.

Additionally, around 2pm I have been developing insulin resistance and my glucose rises to about 200 and stays there until 12midnight. During the night it slowly eases back to normal and is always 100-120 normal when I wake up. According to my sensor, it never goes hypo.

One theory to consider is that the headache and the glucose rise are related, and that they are triggered by the Somiyogi Effect.  I have had periods when my basal insulin wasn't right overnight and I would go low and then bounce back on a "rebound" for about 6 hours of BG at 180-250 (AND a regrettable headache usually hangs around for several hours).
The only reason it doesn't fit in this situation is that I am using a sensor and have records on where I've been on the glucose spectrum. I don't see many readings under 100 during the day. During the middle of the day I might get to 85 on the sensor (which means the actual real time BG might be lower). It's not an adrenaline event, like serious hypos tend to be. The times in the past that I have suffered the Somiyogi Effect it has included a signature headache that was unshakeable for about a day. It was the kind of headache that no pain-reliever could put a dent in.

So... I have considered a few factors and done a few experiments to see if I could stop them.

1) Food: I wondered if intermittent fasting was causing some sort of hormonal event that triggered cortisone or something that might bring a headache and insulin resistance along. I tried eating breakfast, more carbs, more protein, etc. and nothing has seemed to help. The headaches have been the most consistent thing lately...

2) Hydration: I am guilty of neglecting my hydration on days that I am busy at work. I am certain that there have been days that I've given myself a headache from dehydration. However, I have made an effort to drink plenty of water throughout the day many days in the past 2 weeks, and haven't seen a difference.

3) Tea: I noticed that the routine headache was also synchronized with my 2nd cup of strong tea for the day.  Some research on the web showed that some people are sensitive to black tea and get the achey neck and head that I was having. I stopped drinking tea altogether for a week, and I still had headaches (maybe a different type?). However, when I drank tea, they seemed to get worse, or be compounded. Inconclusive... I really love my black tea.

4) Supplements: A while ago, (maybe a month?) I ran out of Alpha Lipoic Acid, and have been living without it. It is a insulin mimetic that reduces my insulin requirements. I expected to increase my basal, but didn't really notice anything change, except this insulin resistance in the PM hours. I have gotten another shipment of ALA and am taking as I had before. I'm looking to see if my BG levels out and stays constant all day, as it did from Aug-Oct.
I have heard that low-Magnesium can cause headaches. So I added Magnesium to my list of supplements. I also added vitamin D and A.

5) Workplace: On Oct. 22nd I realized that I hadn't had a headache that day. It was a day we had a field trip, and I hadn't spent the day in the building where I normally am. I also didn't have tea that afternoon. Maybe something is wrong with my school building? *This weekend, I was waiting for the headaches to hit at their normal time, and they didn't. My BG did rise, as it has lately, but I didn't have the headaches. Right now this seems to be the most likely cause of the headaches... but, unfortunately, it's the issue I have the least ability to solve. I am wondering what types of factors in my school building could cause the headaches. During the weekend I did consume tea and cider with no ill-effects. 

6) Eyes: I had my vision checked this summer and didn't have a significant change in my prescription. When I wear my contacts all day they start to bother me, but I've been off the contacts for a while.

7) Cider: I have been having a nightly pint (or two) of home-brewed hard cider for roughly the same amount of time that this has been going on. It didn't occur to me to consider it as a suspect until I was working through this list. I may have to take a few days off to see if it's a possible culprit. Last winter it was also my beverage of choice and I don't remember anything strange during that time... then again, my BG control wasn't amazing then either.

So, that's my list. I am wondering what I'm missing. If I am a typical T1 diabetic, I have a tendency toward autoimmune problems. I wonder if I could be doing something to aggravate my immune system and create some sort of domino-effect. Could I be a migraine person, sensitive to dark chocolate, coffee and red wine?


  1. Erm, it seems to me that you're missing the very obvious solution to the blood sugars if you have a consistant high blood sugar at the same time of day: you change your basal rates! You should definitely increase your basal rate around 11 AM (or maybe earlier- some people change basal two hours ahead of when they want to see a change- whatever works for you).

    Symogii seems really unlikely given that you're wearing a sensor and it's night after night and also that you've never seen a low there, but when I suspect Symogii, I lower my basals (well, okay, my Lantus) and see what happens.

    Hydration does strike me as a possible cause of your headaches, and high blood sugar, alcohol, and some teas can exacerbate dehydration. I had a full time dehydration headache in the months before I was diagnosed with diabetes and if I wake up after a few hours of being high, I often have a hangover type headache. It used to be that I only needed to get up to around 165 for that to happen; my renal threshhold went up so I don't dehydrate at such low numbers and now it takes numbers around 200.

    But I think you may be dealing with an allergy.

    The other culprits that come to my mind are worse. I suggest that if it's been going on for a month, you talk to a medical professional.

  2. Nathan, I wake up with similar headaches, and I think it's because of rebound issues at night. What you described has fit me perfectly for a while-- I would wake up around 250 frequently, and would be super insulin resistant for the first part of the day. But when I would check my blood sugar at night, it would be normal-- I am pretty sure it was rebounding every night in the wee hours. This sometimes happens during the day, and I have been trying to work it out. I think I over-bolus sometimes, and without actually going low, my liver releases glycogen. Does this make any sense?
    I also agree that magnesium is a good thing to take, and one product that is especially absorbable is Calm-- you mix it with warm water at night, and it also improves sleep.
    Hope it's not the cider!

  3. Hmmm, an allergy to molds or chemicals in the building would be hard... as would a problem with the cider. I know I get achey feelings from whatever ever kind of yeast they use to make wine. I'm wondering if the headaches came back yet. Hope not!

  4. I used to have splitting headaches from hypoglycemic episodes, along with nausea, and they would take the whole day to go away--usually not until the next morning. I don't get those anymore, probably because I've become less sensitive, which in itself is not a good thing.

    If the headaches only occur on school days, that would indicate your work environment--either some physical factor or a difference in your routine. You could try taking an antihistamine and see if it makes a difference.

    You've certainly been very thorough in your analysis. I'm glad the solution hasn't fixed on your black tea...

  5. The type of headache I was getting everyday was most noticeable on weekdays. It was a specific kind of headache. It included aches around the neck and jawline (glands) and sinuses. It seemed like if I pressed my fingers into my eye sockets it would alleviate it some.

    The hypo headaches that I know fairly well are way more inside my head. Like I can feel them at the back of my brain. I think a hypo headache would be the most similar to a hangover.

    Last week I didn't spend concentrated time in my classroom like a normally work week. In fact, only one day was sporadically in my classroom for parent conferences. I will see this week if I see them return as well will be back for 5 days of classroom routine.

    I hope it's not related to my building, but it wouldn't surprise me. Our school was closed due to toxic mold 11 years ago, and the air handling system could still be less than perfect. My classroom is typically too cold.